Impact of hospital-based early detection on management in chronic kidney disease: the CKD Stewardship study (CKD-S) - protocol for a prospective, multicentre, observational cohort study.

Introduction: Chronic kidney disease (CKD) causes significant morbidity and mortality. Medical therapies can reduce the progression of disease by up to 50%. CKD is undiagnosed in the majority of people who have it, resulting in undertreatment.

Assessing the role of education level on climate change belief, concern and action: a multinational survey of healthcare professionals in nephrology.

Background: Climate change poses a significant risk to kidney health, and countries with lower national wealth are more vulnerable. Yet, citizens from lower-income countries demonstrate less concern for climate change than those from higher-income countries. Education is a key covariate.

Factors Associated With Cocaine Use at 17 and 20 Years Old: A Longitudinal Analysis of a Nationally Representative Cohort.

Purpose: Despite growing concerns about trends in cocaine use, there is a shortage of longitudinal research that prospectively examines risk and protective factors associated with cocaine initiation and use in general youth populations. This study addresses this gap.

Methods: Growing Up in Ireland is a nationally representative cohort.

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Background: Cannabis is the most commonly used illicit substance in Ireland and globally. It is most likely to be used in adolescence, a period of biopsychosocial vulnerability to maladaptive behaviours. This study aims to investigate the risk and protective factors for cannabis use among adolescents.

An Evaluation of the Effect of App-Based Exercise Prescription Using Reinforcement Learning on Satisfaction and Exercise Intensity: Randomized Crossover Trial.

Background: The increasing prevalence of sedentary lifestyles has prompted the development of innovative public health interventions, such as smartphone apps that deliver personalized exercise programs. The widespread availability of mobile technologies (eg, smartphone apps and wearable activity trackers) provides a cost-effective, scalable way to remotely deliver personalized exercise programs to users. Using machine learning (ML), specifically reinforcement learning (RL), may enhance user engagement and effectiveness of these programs by tailoring them to individual preferences and needs.

The Training Intensity Distribution of Marathon Runners Across Performance Levels.

Background: The training characteristics and training intensity distribution (TID) of elite athletes have been extensively studied, but a comprehensive analysis of the TID across runners from different performance levels is lacking.

Methods: Training sessions from the 16 weeks preceding 151,813 marathons completed by 119,452 runners were analysed. The TID was quantified using a three-zone approach (Z1, Z2 and Z3), where critical speed defined the boundary between Z2 and Z3, and the transition between Z1 and Z2 was assumed to occur at 82.

A Multinational, Multicenter Study Mapping Models of Kidney Supportive Care Practice.

Introduction: Kidney supportive care (KSC) integrates kidney and palliative care to improve quality of life for people with chronic kidney disease (CKD). Despite increasing interest and global advocacy to integrate KSC into kidney care, evidence to guide optimal care delivery is limited.

Methods: This observational cross-sectional study used an online survey to describe current KSC models in Australia, Aotearoa-New Zealand, and the UK.

Heart failure events in randomized controlled trials for adults receiving maintenance dialysis: a meta-epidemiologic study.

Background And Hypothesis: Heart failure is characterized as cardiac dysfunction resulting in elevated cardiac filling pressures with symptoms and signs of congestion. Distinguishing heart failure from other causes of similar presentations in patients with kidney failure is challenging but necessary, and is needed in randomized controlled trials (RCTs) to accurately estimate treatment effects. The objective of this study was to review heart failure events, their diagnostic criteria, and adjudication in RCTs of patients with kidney failure treated with dialysis.

Geographic and racial variability in kidney, cardiovascular and safety outcomes with canagliflozin: A secondary analysis of the CREDENCE randomized trial.

Aim: To explore the effect of canagliflozin on kidney and cardiovascular events and safety outcomes in individuals with type 2 diabetes and chronic kidney disease across geographic regions and racial groups.

Materials And Methods: A stratified Cox proportional hazards model was used to assess efficacy and safety outcomes by geographic region and racial group. The primary composite outcome was a composite of end-stage kidney disease (ESKD), doubling of the serum creatinine (SCr) level, or death from kidney or cardiovascular causes.

Interparental conflict trajectories across various child residence arrangements when parents live apart.

In Norway, as in most Western countries, a growing proportion of parents living apart choose shared residence for their children. The aim of this study was to investigate trajectories of five interparental conflict dimensions across four child residence arrangement groups (and three combination groups) to improve understanding of different conflict trajectories when parents live apart. We used data from the Dynamics of Family Conflict study.

Climate Change, Kidney Health, and Environmentally Sustainable Kidney Care: A Multinational Survey of Health Care Professionals.

Key Points: A multinational survey of health care professionals on the kidney health impacts of climate change and the environmental burden of kidney care was conducted. Most participants reported knowledge gaps and high level of concern on these interconnected issues. Only a minority report personal or organizational initiatives in environmentally sustainable kidney care; this did not vary by country income level.

'Family first' - feasibility and pilot outcomes of a community intervention for families of children in recovery following brain injury.

Purpose: Feasibility and pilot outcomes of a new community-based program for families of children with acquired brain injury (ABI) are presented. Interventions, delivered by home-visiting and teletherapy, were underpinned by problem-solving therapy, narrative meaning making, goal-directed interventions and community system psychoeducation.

Methods: Eighty-three families of children, who had sustained an ABI before 12 years of age, had an average of 13 sessions of the 'Family First' (FF) intervention.

Estimating a Minimal Important Difference for the EQ-5D-5L Utility Index in Dialysis Patients.

Objectives: The EQ-5D-5L is a commonly used health-related quality of life instrument for evaluating interventions in patients receiving dialysis; however, the minimal important difference (MID) that constitutes a meaningful treatment effect for this population has not been established. This study aims to estimate the MID for the EQ-5D-5L utility index in dialysis patients.

Methods: 6-monthly EQ-5D-5L measurements were collected from adult dialysis patients between April 2017 and November 2020 at a renal network in Sydney, Australia.

Identifying Barriers and Facilitators for Increasing Uptake of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors in British Columbia, Canada, using the Consolidated Framework for Implementation Research.

Background: Care gaps remain in modern health care despite the availability of robust, evidence-based medications. Although sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated profound benefits in improving both cardiovascular and kidney outcomes in patients, the uptake of these medications remain suboptimal, and the causes have not been systematically explored.

Objective: The purpose of this study was to use the Consolidated Framework for Implementation Research (CFIR) to describe the barriers and facilitators faced by clinicians in British Columbia, Canada, when prescribing an SGLT2 inhibitor.

Feasibility of Symptom monitoring WIth Feedback Trial (SWIFT) for adults on hemodialysis: a registry-based cluster randomized pilot trial.

Background: Patients with kidney failure on hemodialysis (HD) experience considerable symptom burden and poor health-related quality of life (HRQoL). There is limited use of patient reported outcome measures (PROMs) in facility HD units to direct immediate care, with response rates in other studies between 36 to 70%. The aim of this pilot study was to evaluate feasibility of electronic PROMs (e-PROMs) in HD participants, with feedback 3-monthly to the participants' treating team, for severe or worsening symptoms as identified by the Integrated Palliative Outcome Scale (IPOS-Renal), with linkage to the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry, compared with usual care.

Effect of Dialysate and Plasma Sodium on Mortality in a Global Historical Hemodialysis Cohort.

Significance Statement: This large observational cohort study aimed to investigate the relationship between dialysate and plasma sodium concentrations and mortality among maintenance hemodialysis patients. Using a large multinational cohort of 68,196 patients, we found that lower dialysate sodium concentrations (≤138 mmol/L) were independently associated with higher mortality compared with higher dialysate sodium concentrations (>138 mmol/L). The risk of death was lower among patients exposed to higher dialysate sodium concentrations, regardless of plasma sodium levels.

The Association of Frailty and Malnutrition With Dietary Intake and Gastrointestinal Symptoms in People With Kidney Failure: 2-Year Prospective Study.

Background: Frailty and malnutrition are both associated with worsening morbidity and mortality and become more prevalent in the elderly and as kidney function declines. Anorexia and reduced oral intake are common features of both frailty and malnutrition. However, there are sparse data evaluating the impact of other gastrointestinal (GI) symptoms, such as taste changes, on rates of frailty and malnutrition in people with kidney failure.

Gender inequities in women's access to maternal health care utilisation in Zambia: a qualitative analysis.

Background: The role of gender inequities in women's ability to access maternal health care has mainly been analysed from either women's or men's perspective only. In this article, we explore the role of gender inequities in maternal health care utilisation from both men's and women's perspectives.

Methods: Thirty-six interviews were conducted with reproductive age women (n = 24), and men whose wives/partners gave birth within the last three years prior to our study in Zambia (n = 12).

Optimising mechanical separation of anaerobic digestate for total solids and nutrient removal.

Mechanical separation of anaerobic digestate has been identified as a method to reduce pollution risk to waterways by partitioning phosphorus in the solid fraction and reducing its application to land. Separators have adjustable parameters which affect separation efficiency, and hence the degree of phosphorous partitioning, but information on how these parameters affect separation performance is limited in the literature. Two well known technologies were investigated, decanter centrifuge and screw press, to determine the most efficient method of separation.